The 20th anniversary of BANTAO (Balkan Cities Association of Nephrology, Dialysis, Transplantation and Artificial Organs)

Nephrologists of the Balkan countries meet across political frontiers and war fronts—an example to politicians!—F. Valderràbano

The Balkan Cities Association of Nephrology, Dialysis, Transplantation and Artificial Organs (BANTAO) was born in Ohrid (Figure 1), Republic of Macedonia, on 9 October 1993 at the first Congress of the Macedonian Society of Nephrology, Dialysis, Transplantation and Artificial Organs (MSNDTAO) [1].

Fig. 1.

Ohrid, R. Macedonia.

At that very moment, bloody wars raged in former Yugoslavia. Fratricide, destruction and cruelty were the norm. Nevertheless, in spite of the hatred and political intrigue, Balkan nephrologists were willing to cooperate with one another. The war in Yugoslavia created hate among people and between the newly established countries. There were even problems with the recognition of the names of the new countries. To overcome this, the nephrologists in the Balkans decided to apply the ancient principle of using the names of the cities, instead of countries, in founding BANTAO (Figure 2). So it came into being as the Balkan Cities Association of Nephrology, Dialysis, Transplantation and Artificial Organs. The idea was to create a nephrology association from the Balkan cities and form a collaboration across the iron gates of borders and beyond the perverse and bloody political nationalistic ideology.

Fig. 2.

Balkan countries after separation of the Former Yugoslavia.

The main goal of BANTAO was to promote scientific and technical cooperation for renal diseases and artificial organs among cities of the Balkan Peninsula and with the international nephrology community. It was important to create opportunities for the exchange of expert experience and knowledge and to take part in collaborative projects. This was a rare opportunity to transcend divisions, obstructions and distrust in this unfortunate and turbulent part of Europe.

A task force was formed from representatives of different cities from the Balkans: S. Kodra (Tirana), D. Nenov (Varna), Z. Kirjakov (Sofia), Gj. Masin (Skopje), M. Polenakovic (Skopje), F. Akcicek (Izmir), E.J. Dorhout Mess (Izmir), Lj. Djukanovic (Belgrade), A. Radmilovic (Belgrade) and S. Strahinjic (Nis).

Momir H. Polenakovic, President of the MSNDTAO, was elected chairman of this task force. Some Western European nephrologists (H. Klinkman, J. Vienken, E.J. Dorhout Mees, D. Falkenhagen and P. Ivanovich), the European Society of Artificial Organs (ESAO) and the International Faculty for Artificial Organs (IFAO) have greatly assisted our initial efforts to establish the BANTAO.

The first BANTAO Congress was held in Varna, Bulgaria from 22 to 24 September 1995 (when the Balkan wars were still at their height) under the presidency of D. Nenov (Varna). The congress in Varna was successful, with >80 papers presented by nephrologists from the Balkans and other European cities. The first BANTAO Congress had a positive impact on the nephrology community in Europe.

Our Spanish colleague, the late F. Valderràbano, published a congress report [2]: ‘Nephrologists of the Balkan countries meet across political frontiers and war fronts—an example to politicians! BANTAO: a new European medical association overcomes political obstacles. This is an extraordinary initiative of nephrologists working in cities throughout the Balkan countries who have been able to create a scientific association and to organize its first congress, despite the boundaries of war, the rupture of international relations and other serious political problems which emerged in the Balkan countries after the disappearance of the former Republic of Yugoslavia. The main goal of BANTAO is to promote scientific and technical cooperation in the field of renal diseases and artificial organs between the Balkan cities. This goal will be achieved not only through a periodical congress, but also through lecturer exchange, fellowship exchange, scientific research methods exchange, joint meetings and courses, publications and cooperation in the field of renal transplant. BANTAO wants to work closely with other international societies and especially with EDTA-ERA. BANTAO represents an extraordinary initiative and should receive both scientific and economic support from the EDTA-ERA. The exceptional effort of collaboration shown by our Balkan colleagues, who have been able to carry out scientific activities in extremely adverse human conditions, is an example to the European nephrological community, which should not hesitate to offer all possible help to this new association’.

As Valderràbano suggested, ERA-EDTA (four supported CME courses) and also ISN (two events) have given encouragement and practical help to the BANTAO congresses. Since that first congress in 1995, BANTAO congresses have been held every 1–2 years. The congresses have been held in nine different cities, located in six different countries of the modern Balkans (Varna, Struga, Belgrade, Ismir, Thessaloniki, Ohrid, Antalya, Chalkidiki, Timisoara) [3].

The recent 11th BANTAO Congress was held from 26 to 29 September 2013 in Timisoara (Romania), on the 20th anniversary of the founding of BANTAO. The president of the congress was A. Schiller. An ERA-EDTA CME programme on kidney transplantation was held as a pre-congress course and Central and Eastern Europe regional workshop of ISN Global Outreach programme during the congress. At the congress, M. Polenakovic, A. Basci, Lj. Dukanovic, D. Nenov and Ch. Stathakis received recognition as founders of BANTAO. J. Feehally, immediate past-president of the ISN, presented M. Polenakovic with the newly established ISN Pioneering Award for his contribution to the development of nephrology in Eastern and Central Europe (Figure 3).

Fig. 3.

J. Feehally (right), immediate past-president of the ISN, is presenting M. Polenakovic (middle) with the newly established ISN Pioneering Award for his contribution to the development of nephrology in Eastern and Central Europe, laudation by G. Spasovski (left).

Another milestone in the life of BANTAO was the appearance of the BANTAO journal in 2003, which has been published biannually since then [4]. In the past 10 years there have been 21 editions of the journal and three supplements reporting BANTAO congresses. The editors of the journal past and present are: 2003–2005 (Dimitar Nenov); 2005–2009 (Ali Basci); 2009– (Goce Spasovski). To date 345 papers have been published. The BANTAO journal is registered on EBSCO, DOAJ, SCOPUS, and has become a strong ‘glue’ among nephrologists from the Balkan cities.

Despite the difficulties imposed by devastating wars and catastrophic earthquakes, BANTAO has flourished through the passion and commitment of nephrologists to their patients and to renal science [5]. The BANTAO Congress has been established as the major scientific and institutional forum for Balkan nephrologists, with its own journal, indicating our will to communicate, to collaborate, to get to know each other, and to share our difficulties and our successes.

What should BANTAO do in future?

1. Improve further cooperation between the nephrologists and physicians from other related medical specialties from the Balkan cities and the colleagues from Europe and the world.

2. Improve basic and clinical education and research in nephrology in the region.

3. Discover, treat and register patients with CKD.

4. Ensure early diagnose of diabetes mellitus and hypertension and halt or delay progression to end-stage renal disease.

5. Establish registries for renal biopsy and for rare renal diseases.

6. Improve renal transplantation and establish a Balkan transplant network, connecting with other renal transplant networks in Europe and the world.

7. Improve the fight against infections (especially against hepatitis C).

8. Organize joint clinical trials.

9. Further improve the quality of the BANTAO journal.

In summary, the BANTAO congresses and the BANTAO journal have succeeded in elevating nephrology knowledge [6] and thus increased the standards of nephrology patient care throughout the Balkans. Standing above the divisive forces of politics, language and war, BANTAO gives a living example that collaboration and humility are feasible in times of maddening destruction, and are transformative.

Conflict of interest statement

None declared.